Abstract
Alcohol use is a major risk factor associated with unprotected sexual behavior, leading to higher risk of sexually transmitted infections (STI) including the human immunodeficiency virus (HIV). Emerging largely crosssectional data suggest functional network connectivity strength is associated with problematic alcohol use, and as evidence supports a relationship between risky sexual behaviors and alcohol use, we hypothesized that functional connectivity might be associated with both categories of risk behavior. As part of a sexual risk reduction intervention study, juvenile justice-involved adolescents (N = 239) underwent a baseline functional magnetic resonance imaging scan and completed questionnaires about their alcohol use and risky sexual behavior at 3-month intervals over 12 months of follow up. To test both cross-sectional and longitudinal relationships between alcohol use and sexual risk behaviors, we estimated a parallel process latent growth model that simultaneously modeled the trajectories of alcohol use and sexual risk behavior. Functional connectivity strength was included as an exogenous variable to evaluate its relationship with level of risk and change in risk over time in both behaviors. Associations were found between baseline alcohol use and risky sex, and between longitudinal trajectories of alcohol use and risky sex. Network functional connectivity strength of the dorsal default mode network was associated with initial and longitudinal alcohol use, which may suggest that selfawareness of the effects of alcohol could serve as a useful target to decrease subsequent risky sexual behavior in adolescence.
Keywords: Adolescence, alcohol, default mode, functional connectivity, juvenile justice, risky sex.
Graphical Abstract